Antibiotic resistance in bacteria is compromising our ability to treat infection. Of alarming concern is emerging carbapenem resistance amongst members of the Enterobacteriaceae (so called carbapenem-resistant Enterobacteriaceae or CRE) such as Klebsiella pneumoniae and Enterobacter spp. Heretofore, carbapenems were the class of antibiotics of last resort against multidrug-resistant pathogens. Acquisition of broadly acting enzymes that destroy these drugs has made treatment of CRE problematic at best. Alternative treatments are either absent or highly toxic. Accordingly, the CDC has classified CRE as an urgent threat. There is pressing need for novel antimicrobials and new antimicrobial target identification. Importantly, bacteria containing the same functional carbapenemase enzymes show marked differences in susceptibility to carbapenems, suggesting that carbapenem resistance is multi-factorial. In fact, some strains remain clinically susceptible both in vitro and in vivo. We therefore hypothesize that novel adjunctive antimicrobials can be found that modulate factors contributing to resistance and thereby restore the efficacy of carbapenems in non-susceptible strains. Therefore, this proposal will use a comprehensive, high-throughput screening (HTS) assay to identify novel compounds that either directly inhibit CRE and/or render CRE susceptible to carbapenems. Following identification, we aim to characterize the mechanism of action of these novel compounds and gain insight into mechanisms of carbapenem resistance and CRE antimicrobial effect. The long-term goal is to use this knowledge to develop novel effective therapies for CRE.

Public Health Relevance

Antibiotic resistance in bacteria, specifically multidrug resistance among Carbapenem-Resistant Enterobacteriaceae (CRE) has resulted in the emergence of essentially untreatable infections. This proposal aims to identify novel compounds that work alone or in synergy with carbapenem antibiotics to identify treatments for these infections and to extend the useful lifetimes of existing antibiotics.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Postdoctoral Individual National Research Service Award (F32)
Project #
5F32AI124590-02
Application #
9570626
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Xu, Zuoyu
Project Start
2017-08-27
Project End
2020-08-26
Budget Start
2018-08-27
Budget End
2019-08-26
Support Year
2
Fiscal Year
2018
Total Cost
Indirect Cost
Name
Beth Israel Deaconess Medical Center
Department
Type
DUNS #
071723621
City
Boston
State
MA
Country
United States
Zip Code
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Smith, Kenneth P; Kirby, James E (2018) The Inoculum Effect in the Era of Multidrug Resistance: Minor Differences in Inoculum Have Dramatic Effect on MIC Determination. Antimicrob Agents Chemother 62:
Truelson, Katherine A; Brennan-Krohn, Thea; Smith, Kenneth P et al. (2018) Evaluation of apramycin activity against methicillin-resistant, methicillin-sensitive, and vancomycin-intermediate Staphylococcus aureus clinical isolates. Diagn Microbiol Infect Dis 92:168-171
Kang, Anthony D; Smith, Kenneth P; Berg, Anders H et al. (2018) Efficacy of Apramycin against Multidrug-Resistant Acinetobacter baumannii in the Murine Neutropenic Thigh Model. Antimicrob Agents Chemother 62: